I should really check my e-mail more often. Check it out; remember that post I did about the movie, Private Practices: The Story of a Sex Surrogate? I said I’d e-mail the organization mentioned in the film, IPSA, with some questions, and someone answered me!

I asked:

So far the questions I have gotten are, how would surrogacy work if a female client is a sexual pain patient, and in a heterosexual relationship – what sort of things would a surrogate do for the couple? Would the surrogate act as a stand-in for the female patient, or (this is what I was thinking) would the surrogate demonstrate pleasurable sexual techniques on both partners?

The other question was, what is the percentage of male surrogates (presumably the asker means within the USA)?

My own would question would be, how would one go about finding a surrogate who is equipped to handle pelvic pain patients?

And a representative, Shai Rotem, e-mailed me back (Name and response is being used with permission:)

1. The basic structure of surrogate partner therapy consists: Client-Sex therapist-Surrogate partner. In cases of female with sexual pain disorders, there is one more professional the client should work in conjunction with: physical therapist who specializes in pelvic floor muscles. From our experience in this way work (client + surrogate partner + sex therapist + physical therapist) most of the cases get 100% of success.

2. Surrogate therapy was designed for people without partners. So, in case of couple, they both, together have to see a sex therapist. They have each other to practice with, most sex therapists will give them some homework – experiential exercises they have to do at home. It could be some techniques of touch, some sexual behaviors, readings, watch videos etc.

3. There are more female surrogate partners than male surrogate partners and that because there is a lot more demand. There are a lot more men seeking surrogate partner therapy.

4. The best way to find a certified surrogate partner is contacting IPSA by e-mail. Our associate will help with referral and locate a surrogate partner in the clients’ location. they can use this e-mail address: referrals@SurrogateTherapy.org

“I’ll tell you what I do. I work with men who have sexual dysfunctions as their partner and I practice sex with them and I practice social skills & I practice communicating & I practice teaching them how to love people.” ~Maureen Sullivan in Private Practices: The Story of a Sex Surrogate.

I finished watching a documentary on sexual surrogacy. Private Practices: The Story of a Sex Surrogate, directed by Kirby Dick – the same man who directed (among other things,) This Film Is Not Yet Rated. It was filmed during the early 1980s – right at the beginning of the AIDS crisis, and long before Viagra and mainstream access to the internet.

Sexual surrogacy is an interesting topic to me, in large part due to its rarity as a therapeutic tool. How many people have even heard of it?

The first exposure I had to the idea of sexual surrogacy came from (of all places,) an erotic novel. As the setting in that novel was the late 1700s, and the book was fraught with grammatical & factual errors & stretchings of the truth, I didn’t think much of it.
Then, Anne Sprinkle touched upon it in her book, Spectacular Sex, in describing how a physically disabled person was able to have a sexual experience with the aid of a surrogate. Huh, maybe that erotic novel author was onto something.
Then there came a Feminist Review of Private Practices.

Wait, there’s a movie about this?

I’ve heard of sex therapy before, in terms of talk therapy & couples’ therapy. You go in, talk to a counselor, psychologist, or psychiatrist, and work through your thoughts, emotions & physical problems as they relate to sex. It shouldn’t matter if you have a partner or not; the therapist should be equipped to handle you (your mileage may vary.) You might be given homework assignments to finish before your next session. And I’m personally familiar with dilators and physical therapy as hands-on healing tools for vulvovaginal pain. (Dilators & PT are surprisingly unsexy treatments. Effective for me, but clinical almost to the point of sterility.)

Sex surrogacy is something a little different.
So what is it?

This is a real thing. The same organization that Maureen Sullivan was president of at the time of filming, is still around – the International Professional Surrogates Association. If you watch the film with the director’s commentary on, you’ll hear Kirby Dick and his interviewer talking about how surrogacy was gaining popularity as a treatment for sexual dysfunction, until the AIDS crisis hit and derailed it due to safety concerns.

In this therapy a client, a therapist and a surrogate partner form a three-person therapeutic team. The surrogate participates with the client in structured and unstructured experiences that are designed to build client self-awareness and skills in the areas of physical and emotional intimacy. These therapeutic experiences include partnerwork in relaxation, effective communication, sensual and sexual touching, and social skills training. Each program is designed to increase the client’s knowledge, skills, and comfort.

The website goes on to list some problems that sex surrogacy can address and Wikipedia includes painful intercourse as one area. Although sex surrogacy is described as appropriate in some cases for both men & women, the impression I got from Private Practices, Wikipedia, and IPSA is that it puts a stronger focus on men than women. I get this impression because all three resources explicitly point out conditions that men experience – notably erectile dysfunction & premature ejaculation.

One of the big questions I’m still left with is, whether or not this counts as a form of sex work. There can be exchange of sex for money, and intensive therapy can be expensive. You don’t need to have any special qualifications or degrees to be a surrogate, although you should go through training with IPSA. The legality of surrogacy is dubious. And indeed, a text block at the beginning of Private Practices notes that the film would likely raise moral & ethical questions – questions that the IPSA attempts to address with its Code of Ethics.
However, According to R.J. Noonan, PhD., sex work and surrogacy should not be mixed up. Much of a surrogate’s time is going to be spent doing non-sexual activities & coaching. But then, is this distinction being made because sex work is so stigmatized? Would there be a distinction if sex workers were more respected?

The movie asks that rather than fixating on these questions, the viewer should focus on the lives of the subjects being filmed.

So how is the film, anyway? Is it worth a rent from Netflix? Does it answer any questions? Who might be interested in the movie? Well,

The first thing that struck me before the content was the quality of the film itself. The DVD is of a good quality, not a lot of extra features, but it runs smoothly. However the cinematography itself is definitely showing its age – it’s old.
It’s old, and it’s a documentary, so the director didn’t have millions of dollars to work with. The quality of the film (regardless of the content) reminds me of an old home movie or a soap opera. If you watch the movie with the director’s commentary on, Kirby and his interviewer, Tonner Barclow (might not be spelling that right,) say that this film could be an “80s time capsule” in and of itself. Everyone is wearing clothes that you would have definitely seen in the 1980s (The commentary includes a line like, Maureen’s blouse looks like it came from a set of the Golden Girls.) Home decor (Maureen works from home) is circa late 1970s & early 80s. Big hair abounds.
The sound quality is mixed – you can definitely hear everyone speak clearly, but you can also hear airplanes flying overhead outside of the houses.
The worst quality anything though, is the music. The music used in this film is awful. It’s described as ‘Avant garde,’ but it sounds like 1980s Synthesized Stock Music you could have bought in bulk and used to produce mass quantities of After School Specials (although in the director’s commentary, Dick says he knew the music arranger personally.) It hurts my ears. Luckily there’s only a music overlay for like 3 or 4 parts.

The second thing that stood out to me first was how the film conflates sex with love. You can have both at the same time, and perhaps more often than not that is the case. But, sex and love can exist exclusively of each other. You do not require an emotional connection to have sex; the film made it sound like sex = love.
However the director’s commentary notes that the surrogacy movement grew out of the Free Love movement, so “Love” may mean something different from what I’m used to in that context.

The film follows Maureen Sullivan and two men over the course of their months-long therapy, set in Los Angeles, California. Both patients are referred to Maureen through their therapists. We do not see how the patients & their regular therapist came to the conclusion that sex surrogacy was an option. We do not see what probing questions must have been asked. The director paid for Kipper & John’s therapy in exchange for allowing it to be filmed. (Did either one of them expect to see a revival of the film after 25+ years? Are they even still alive? We do not know.)

The first client we meet is Kipper, a 25-year old student & virgin who is so shy around women that he cannot form meaningful relationships with them. No, really; you may think that he’s just saying that so he can come across as a stealth-creepy Nice Guy, but I genuinely believe that he was afraid of women. He shows discomfort around Maureen even as she tries to lower his barriers through talk & touch therapy.

In the director’s commentary, Kirby & his interviewer question if Kipper was gay, and trying to “Cure” himself through surrogacy. The directors note here that that’s not really an appropriate use of surrogacy (and it probably wouldn’t work.) Kipper, as it turns out, has an older brother who strikes me as a real “Bro” type, while Kipper is much more introverted. We don’t learn much else about Kipper’s life and why he is so shy around women. He did not spend much time with his mother, and, it seems that he did not receive much affection from her as a youth. Indeed, when Maureen and Kipper finally embrace on her couch, her touch is more Maternal than sexual, or even friendly.

We do not see Maureen’s first session with Kipper (so says the director’s commentary,) so what you see when we first meet Kipper really cuts to the chase. It starts off right away with touch therapy. (We do not see any questions of consent discussed; hopefully surrogate & patient have an understanding of consensual vs. non consensual touching & respecting other people’s boundaries in a non-therapeutic setting.)

The second patient is 45-year old John, a newly divorced teacher after 20 years of marriage. John’s primary complaints are feelings of sexual inadequacy (exacerbated by mean comments made by his sex partners,) erectile dysfunction & premature ejaculation – although as the film goes on we learn that his problems likely go deeper than that.

John may be overestimating the importance of sex & sexual performance, to the detriment of every other area in his life. Going into the patient/surrogate relationship, he automatically assumed that he would fall in love with Maureen, and she with him (Entitlement much?) While he thought poor sexual performance was the primary reason for his divorce, his ex-wife appears on film to state that no, that wasn’t one of her real concerns.

It seems that nobody likes John. His ex-wife doesn’t like him and calls him a “Slob.” In the commentary the director says he engaged in pathological hoarding at home, and even Maureen calls him a “Cheapskate.” Maureen is somewhat open about her discomfort with John – when he says things that make her uneasy, she says so, framed in the larger context of therapeutic benefit. Yet he has two happy daughters at home – who nonetheless chide him for seeking out younger partners instead of women his own age.

The director filmed some of Kipper & John’s individual therapies. Both clients spend time nude with Maureen in front of mirrors, talking about their bodies. Both clients undergo touch therapy; Kipper’s looks more like sensual massage & sensate focus to me, while John’s consists of Maureen training him how to avoid premature ejaculation by masturbating him (out of frame.)
This is probably the most explicit and uncomfortable scene in the whole movie.
But, this was also back in the day before Viagra, so it’s not like John could have just popped a pill and problem solved.

Maureen also lets both patients explore her body and genitals sexually, trying to show them some techniques (with mixed results.) What’s really odd to me here is that, Maureen spends a lot of time talking about her vagina, but no time talking about her clitoris. Why is that? If you are trying to teach pleasurable technique on a female bodied person, shouldn’t you at least speak the word, “Clitoris?” Or “G-spot?” Or something like that?
On the other hand, I must also acknowledge the wide variety of what gives women pleasure. Perhaps Maureen enjoyed vaginal stimulation more than clitoral?

No intercourse was caught on film, and, if I’m understanding the director’s commentary correctly, there wasn’t any with either of these clients anyway.

One of the most revealing scenes does not involve patient and client at all. Kirby brought Maureen, her brother and father together for the climax of the film. Maureen and her brother confront their father about what Maureen’s career is (The quote at the beginning of this entry is taken from that scene,) and about how witnessing thier father’s abuse impacted their lives. Maureen and her brother both witnessed (if not experienced) physical abuse by their father. He reacts to their confrontation with a blank stare. I don’t think he was ready to admit that what he did was wrong and how long-lasting the effects of witnessing this abuse was. Maureen candidly admits that part of her motivation in becoming a surrogate, was to seek out what love is supposed to be like. For Maureen, surrogacy is a learning experience too.

The film leaves a lot of questions unanswered, but I suppose that is the nature of the work. After completing any therapy, I’m sure some patients stay in contact while others lose touch. In this case, Kipper & John eventually lost touch. We learn at the end of the film that two years on, Kipper has had some dates, John is in a relationship and Maureen has a boyfriend. After that we don’t know what happened to John or Kipper. They may still be out there, posting on FaceBook or eating a snack even as we speak. The director’s commentary reveals a little more about Maureen, as he stayed in contact with her.

Other questions unanswered though, include the practical application of surrogacy for – pretty much any other case. For what kinds of dysfunction would this be most appropriate? How have Viagra and other medications, the mainstreaming of sex toys, the internet, internet pornography, and laws impacted business? How would a surrogate address female sexual dysfunction, including sexual pain? What steps do surrogates take to minimize the spread of sexually transmitted infections? How does this compare to mainstream sex therapy? How would you find a therapist who is prepared to refer you to a surrogate, or do you seek one out without a referral? What makes a good surrogate? Do surrogates face the same dangers as sex workers? If you have a sex partner, how do you communicate a desire to seek out a surrogate? Is it like starting an open relationship? Is this therapy covered by insurance?
I’m sure there’s more questions even I haven’t thought of.

I think a lot of the therapies Maureen used could have been executed within a mainstream sex therapy setting, without a surrogate. Kipper may have been able to benefit from getting a professional massage at a spa before letting Maureen (or any other partner) give him one. That could have been a homework assignment to address social anxiety around new people, anxiousness about being touched, and relaxation. Professional massage with a licensed therapist isn’t the same as sensual or sexual massage like Maureen was engaged in, and therefore may have been easier to start with. Likewise, if Maureen had had access to the internet, she may have been able to direct John to helpful websites to help address his social skills and premature ejaculation. And self-reflection exercises – like standing in front of the mirror and talking about how you feel about your appearance – that can be done at home alone, with paper & pencil.

As for the movie itself, it’s definitely one of the more… unique movies I’ve seen, even for a documentary. It would be worth watching if you have an interest in sexuality, sexual dysfunction (especially male sexual dysfunction… strong emphasis on male sexual dysfunction,) or possibly sex work.
For everybody else, it’s definitely catering to a niche market. If you have a nosy family, you might even have to hide the DVD from prying eyes. And, because of the sexual content, it may be triggering to those with a history of sexual abuse.

One final note: I would not consider this to be porn. If you rent this expecting it to be porn, you’re probably going to be disappointed. There’s sexually charged scenes, but … it’s… rarely sexy. The final line in the director’s commentary sums it up best: if you’re looking for porn, this is more like “Emotional porn.”

So if you’re looking for a good comedy, thriller, romance, or anything else, look elsewhere.
Basically, only watch it if it sounds remotely interesting. All others, save your time & money.

The discussions & information on this site are not medical in nature and should not be substituted for medical advice from a trained professional. This site is not intended to diagnose, treat, or cure any problems.

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